Infectious respiratory diseases such as the current COVID-19 have caused public health crises and interfered with social activity. Given the complexity of these novel infectious diseases, their dynamic nature, along with rapid changes in social and occupational environments, technology, and means of interpersonal interaction, respiratory protective devices (RPDs) play a crucial role in controlling infection, particularly for viruses like SARS-CoV-2 that have a high transmission rate, strong viability, multiple infection routes and mechanisms, and emerging new variants that could reduce the efficacy of existing vaccines. Evidence of asymptomatic and pre-symptomatic transmissions further highlights the importance of a universal adoption of RPDs. RPDs have substantially improved over the past 100 years due to advances in technology, materials, and medical knowledge. However, several issues still need to be addressed such as engineering performance, comfort, testing standards, compliance monitoring, and regulations, especially considering the recent emergence of pathogens with novel transmission characteristics. In this review, we summarize existing knowledge and understanding on respiratory infectious diseases and their protection, discuss the emerging issues that influence the resulting protective and comfort performance of the RPDs, and provide insights in the identified knowledge gaps and future directions with diverse perspectives.

Fire smoke, rich in toxic ultrafine particles and polycyclic aromatic hydrocarbons (PAHs), poses significant health risks to first responders and vulnerable populations. In this study, a reproducible combustion–smoke simulation platform was developed to mechanistically quantify fire behavior, particle emissions, and PAH toxicity under controlled heat flux and oxygen conditions. Consistent combustion and smoke emissions were achieved by measuring heat release rate, particle mass, particle number concentration, and PAH concentration, with an overall average coefficient of variation below 15%. Systematic experiments with representative biomass (pine, oak) and plastics (PVC, polystyrene) demonstrate that fuel composition, heat flux, and oxygen availability jointly govern particle formation and PAH partitioning. Regardless of the combustion factors, ultrafine particles dominated the particle number concentration (55.5–86.2%). Plastic combustion generated 7 to 59 times particle mass, up to 260 times higher PAH emissions, and up to 58,500 times greater PAH toxic equivalent quotient (PAH-TEQ) than wood. Oxygen-deficient and smoldering regimes shifted emissions toward fine and ultrafine particles enriched in high-molecular-weight PAHs, revealing a coupled physical–chemical hazard not captured by bulk PM metrics alone. These results establish a quantitative framework linking combustion regime, particle size, and PAH toxicity, providing critical insight for exposure assessment, PPE design, and mitigation strategies in ventilation-limited and mixed-fuel fire scenarios.

Firefighters are exposed to complex combustion products and to contaminants carried on personal protective equipment (PPE). Occupational exposure as a firefighter is classified as carcinogenic. This review summarizes the current evidence on exposure environments, routes of uptake, contamination and secondary exposure from PPE, and the effectiveness and limits of decontamination approaches. Across incident types, smoke composition varies with the fuels and combustion conditions, but fine and ultrafine particles and semi-volatile organic chemicals are common. Biomonitoring confirms uptake after incidents. Self-contained breathing apparatus reduces inhalation exposure during active suppression, yet exposures persist through dermal absorption at ensemble interfaces and post-incident tasks. Protective ensembles can retain soot-bound polycyclic aromatic hydrocarbons, additive chemicals, and metals; volatiles and particles resuspension in vehicles and stations can extend exposure. Studies show that on-scene preliminary exposure reduction and laundering can lower contaminant burdens on PPE; however, removal remains incomplete and decreases when cleaning is delayed or when gear is aged. Emerging evidence raises additional concern for per- and polyfluoroalkyl substances from foams and coating materials, with limited data on exposure metrics and removability. The field lacks standardized, realistic contamination platforms and a dose-based definition of clean PPE. Integrated intervention studies linking exposure, secondary exposure pathways, biomarkers, and decontamination methods are needed to set performance-based targets and evaluate emerging hazards.

Firefighter hoods are essential components of personal protective equipment (PPE), protecting the head, neck, and shoulders from extreme heat and hazardous particulates. This comprehensive review evaluates recent hood design and material innovations aimed at improving comfort and protective performance. Traditionally, firefighter hoods mainly focused on thermal insulation but lacked effective particulate filtration, which posed significant health risks. Recent updates to several standards set by the US National Fire Protection Association have led to advanced mul-ti-layered hoods incorporating innovative materials for improved performance. Nevertheless, challenges remain in achieving an optimal balance between comfort and protection. Firefighter hoods must not hinder movement or increase heat stress, and the process of donning and doffing must minimize contamination risks. Current standards primarily assess material properties but fail to address practical, real-world conditions and interactions with other PPE components. This review emphasizes that these knowledge gaps can only be closed through systematic performance evaluations that replicate actual firefighting scenarios and include both human trials and simu-lations. Future research should focus on refining hood designs and materials to enhance particulate filtration efficiency, improve ergonomic fit, and reduce complications associated with use. This will ensure that firefighter hoods offer comprehensive protection while maintaining high comfort levels in demanding environments.